Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Jan 1987
Case ReportsUnilateral facial telangiectasia macularis eruptiva perstans.
A 36-year-old man developed unilateral facial telangiectases over a 10-year period. Histopathologic examination showed collections of mast cells. ⋯ The differential diagnosis of facial telangiectases is discussed. Mastocytosis should be considered in patients presenting solely with telangiectases.
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The skin and mucosal changes in vitamin deficiency are described. Pellagra, which is the oldest known cutaneous manifestation among vitamin deficiencies, is reviewed. Cutaneous alterations caused by deficiency of the water-soluble vitamins B6, C, B1 and biotin, B12, folic acid, and riboflavin result in more mucosal alterations and are discussed. Alterations caused by fat-soluble vitamin deficiencies (vitamins A and K) are also considered.
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J. Am. Acad. Dermatol. · Jul 1986
Case ReportsOral acyclovir for the prevention of herpes-associated erythema multiforme.
Herpes simplex virus is the single most common precipitator of erythema multiforme. Typically, erythema multiforme lesions appear 10 to 14 days after a recurrent herpes simplex virus infection and attacks can be disabling when they occur at frequent intervals. ⋯ Four patients were treated with a maintenance dose of acyclovir for periods ranging from 10 to 26 months; there were no significant side effects from the drug and only one recurrence of erythema multiforme. Oral acyclovir may become the treatment of choice for herpes-associated erythema multiforme.
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Bullous pemphigoid is a chronic blistering disorder characterized by specific clinical, histologic, and immunofluorescent findings. Several variants have been described, including pemphigoid nodularis, which may mimic or evolve from or into prurigo nodularis. ⋯ Direct immunofluorescence then confirmed the diagnosis of bullous pemphigoid. Apparently this patient had prurigo nodularis and then developed bullous pemphigoid.
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A patient who developed exfoliative erythroderma 11 days after the initiation of hydroxychloroquine treatment for psoriatic arthritis is presented. Our experience with her and the continued controversy regarding the incidence of adverse reactions in psoriatic patients to antimalarials prompted a detailed review of the literature. We conclude that the use of antimalarials in patients with psoriasis is associated with a high incidence of severe cutaneous adverse reactions. These medications should not be used in psoriatic patients if other less toxic, effective therapies are available.